Member Case Study: Torn Soleus

On the first rep I tore my soleus muscle. Am I ok to swim? How long should I avoid running? Will using an elliptical trainer be ok?

Question from Lauren61I am a novice training to do Ironman NZ in March 07. I am not a natural runner, but I’ve got my run sessions up to ninety minutes over a few months. I have struggles with low level Achilles tendonitis, but seemed to be getting this under control. However I couldn't help myself at the gym two days ago, and while there to do core exercises, I jumped on the calf raise machine, fully stretched and warmed up. On the first rep I tore my soleus muscle right at the musculotendinous intersection. The weight I was lifting is well under my usual, but was too much for the day.

I am walking with a limp, and cannot go down stairs, but am otherwise ok. I am still biking (on a trainer, so I don't have to make unexpected moves).

Am I ok to swim? How long should I avoid running? Will using an elliptical trainer be ok? It is a real blow to have to drop volumes back at this stage? I will do what I can to reach the long term goal.

Please advise.

Answer from John Odom MD MPH

A soleus tear can be a setback, but shouldn’t be career ending or even deter you from your current goal of doing the Ironman in March of 2007. If there is any consolation from your injury, it is that it occurred early in your training. Depending on the degree of tear, it is reasonable to let pain be your guide. Your inclination to do exercises that are pain free is a good move.

Continuing to keep up your cardio without further strain on the soleus is wise. Swimming is good, especially if you do more swimming where you take your legs out of the work out. You may be able to run as soon as you can walk without a limp, as long as you ease into it, and minimize your risk of further injury by being on a even surface, keeping low intensity, doing low mileage, and wearing a good shoe orthotic with heel lift, etc. Regarding the elliptical, I would use it with caution. The range of motion involved in the affected foot, though lower impact than running, may strain the soleus.

As an anecdotal bit of encouragement, I had a high mileage runner two months before his marathon get a substantial soleus tear, and after a good course of rehabilitation and activity modification was able to run his marathon—not his personal best, but he was able to finish comfortably. I think with the right rehab and modification you will still be able to achieve your goal.

Author

AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

Author

AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.